My OP/ED in LA Times today

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Rick A

climber
Boulder, Colorado
Jul 9, 2015 - 07:16am PT
Ken,

Excellent article, thanks for writing it.

A recent New Yorker article discussed the effect of the doctor-assisted euthanasia, which is permitted by law in the Netherlands and Belgium.

http://www.newyorker.com/magazine/2015/06/22/the-death-treatment

This law apparently allows doctor-assisted suicide even for psychological distress and this is causing some to reconsider the effects of the law. The article focuses on a son who was angry that a doctor agreed to assist his mother in her suicide.

In the past five years, the number of euthanasia and assisted-suicide deaths in the Netherlands has doubled, and in Belgium it has increased by more than a hundred and fifty per cent. Although most of the Belgian patients had cancer, people have also been euthanized because they had autism, anorexia, borderline personality disorder, chronic-fatigue syndrome, partial paralysis, blindness coupled with deafness, and manic depression...

The laws seem to have created a new conception of suicide as a medical treatment, stripped of its tragic dimensions. Patrick Wyffels, a Belgian family doctor, told me that the process of performing euthanasia, which he does eight to ten times a year, is “very magical.” But he sometimes worries about how his own values might influence a patient’s decision to die or to live. “Depending on communication techniques, I might lead a patient one way or the other,” he said. In the days before and after the procedure, he finds it difficult to sleep. “You spend seven years studying to be a doctor, and all they do is teach you how to get people well—and then you do the opposite,” he told me. “I am afraid of the power that I have in that moment.”

I know this is a completely different issue than what your article deals with: people taking control of the circumstances of their own deaths when faced with a terminal diagnosis, but would love to hear your thoughts on it.

Ken M

Mountain climber
Los Angeles, Ca
Topic Author's Reply - Jul 9, 2015 - 10:59am PT
Rick,

The quote you posted says well what American doctors fear most: the gravitation to "death as therapy" for non-terminal conditions. It is not clear to me the logic of restricting termination to people who have a terminal illness with 6 months or less.....that is quite arbitrary.

Mixing arbitrary with ethics seems to produce chaos such that anything you want to do becomes ethical.

The fact is that there are options available to patients right now, that happen every day.

I've mentioned that patients currently have the legal right in all 50 states to give up eating and drinking to hasten their demise. It is one of the gentlest ways to go. In Oregon, in nursing home settings, twice as many patients make that choice as do Physician Assisted Suicide.

I have often asked my doctors, why a patient, (me) cannot have their life terminated?

In the profession gallows humor, this is referred to as a "38-caliber brain biopsy". But you have to do it yourself.

More seriously, doctors have spent a very long time in the pursuit of helping patients to live. It really goes against the grain to kill people.
Once you have trained doctors to kill people, then the issue becomes "when"?

The reality is that very few problems that people fear while dying cannot be adequately addressed. And even for those very rare situations, we have tools to prevent suffering. For example, one is "terminal sedation", in which we basically provide general anesthesia, where a person will feel no pain, and suffer no indignities of which they are aware.

The problem we have, though, is not enough docs trained in these things, called "Palliative Care" specialists.

In my opinion, if a person has severe pain, we should be using the tools to relieve their pain, not killing them instead.
Clint Cummins

Trad climber
SF Bay area, CA
Dec 8, 2016 - 09:59pm PT
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MikeL

Social climber
Southern Arizona
Dec 8, 2016 - 10:33pm PT
I don’t get it. What stand or position is the author taking? What does he want?

It seems what’s wanted are clear delineations of responsibility and authority.

When it comes to visions, I think delineations can’t be created.

Like language, the law or a code of work / professional ethics changes with the times and place. Language, law, and ethics are all living things that reflect who we think we are. (For a reference, see "Judgement at Nuremburg.)

For me, that’s the question: not how to approach the right to death or life, but who or what makes the request to either.

Doctors, like every other profession and work ethic, serve the collective first.

After saying what the focus / unit of concern is, then the question seems to be about how best to serve.
Jon Beck

Trad climber
Oceanside
Dec 9, 2016 - 08:28am PT
Doctors, like every other profession and work ethic, serve the collective first.

Not a doctor, but I suspect that doctors have a singular duty to patients. Taking the good of society into account when advising a patient is a slippery slope.

Does a CPA have a duty to society to see that people pay more taxes?

Lawyers have a duty to their clients, society be damned. A lawyers duty to advocate ends when the client wants to lie in court or is engaging in criminal conduct. However a lawyer can not disclose a clients past lies or criminal activity. The disclosure of planned or possible future criminal activity becomes an ethical quagmire.
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